…phagocytosis is enhanced by opsonins CORRECTION – C3b (and not C3a) is the opsonin. 13 IV.E.1 06/21/2011 (IgG and C3a) Should read “(IgG and C3b)” CORRECTION – Ecchymoses are >1cm and purpura are Symptoms of skin bleeding include petechiae, 31 II. B. 2. > 3mm. Should read “…include petechiae, purpura 06/21/2011 ecchymoses (> 3mm), purpura (> 1 cm)… (>3mm), and ecchymoses (>1cm)” Aminolevulinic acid dehydrogenase (ALAD) TYPO – The enzyme is ALA dehydratase (not 43 IV. B. 2. 06/21/2011 converts ALA to porphobilinogen dehydrogenase). CLARIFICATION – More recent studies show that hemolysis occurs throughout the day. Hence, the color change (hemoglobinemia) seen in the first void upon awakening is mostly due to urine production and Intravascular hemolysis occurs episodically, 49 I. B concentration of hemoglobin overnight (as opposed to 06/21/2011 often at night during sleep hemolysis occurring mostly at night). Of note, my explanation in the text remains partly true and is an excellent way to remember the pathophysiology of this disorder. CLARIFICATION – Nitrates do result in coronary artery vasodilation. However, a more significant effect is 74 G. 3. Nitrates – vasodilate coronary arteries vasodilation of veins. This results in decreased venous 06/21/2011 return to the heart, which in turn, decreases preload and, hence, stress on the myocardium. Table 9.5, Squamous cell carcinoma (under 96 Kertain pearls or intracellular bridges TYPO – “intracellular” should read “intercellular” 06/21/2011 characteristic histology) CORRECTION – The gastroduodenal artery lies posterior May rupture leading to bleeding from the to the duodenum. Hence, rupture of a posterior (and not 105 VI. B. 3. gastroduodenal artery (anterior ulcer) or anterior) ulcer would lead to bleeding from the GDA. 06/21/2011 acute pancreatitis (posterior ulcer) Should read “…gastroduodenal artery (posterior ulcer) or acute pancreatitis (posterior ulcer).” CLARIFICATION – ‘Tram-track’ appearance can be seen Thick glomerular basement membranes on in both type I and type II MPGN. However, it is more 128 V. A. 06/21/2011 H&E, often with ‘tram-track’ appearance commonly seen with type I (USMLE examiners do ask about this!). CORRECTION – The crystals in gout exhibit negative birefringence (and not, positive birefringence). This is 199 Fig. 18.9 Gout. A, Tophi. B, Postive birefringence. 06/21/2011 correct in the text, but needs to be corrected in the image caption.